Three years ago, Carol Steckel, Alabama’s Medicaid director, sent a national alert to all of her counterparts around the country. She asked them to join her in attacking fraudulent prices published by major drug makers — prices that she said inflated the amount all states were paying to pharmacies.
At the time, Alabama had won three lawsuits against drug manufacturers on the grounds that published prices were artificially high. Steckel was working on an entirely new way to set drug prices for Medicaid beneficiaries, one that aimed to lower Alabama’s overall costs, but also remain sensitive to the needs of local pharmacies to make a profit.